Kidney Disorders Community

The obvious thing would be to lower the lithium exposure, but in the vast majority of cases this just isn't possible for the patient.

You would however want to limit exposure to other nephrotoxic aggents like IV iodine contrast, NSAIDS pain relievers, etc. This sort of renal damage can almost never be reversed so the goal is to slow it down.

1.14 is not a terrible number really; some labs consider this in the 'normal' range.

The low BP and the elevated MCV make me wonder if you might be a bit dehydrated all the time. Also hypothyroid might cause these two.

I can't comment on the liver enzymes (ALT and others) but unless it is pretty drastically out of range and some of the other liver enzymes are also showing odd numbers, it may not really be a concern. Ask your doc.

Thank you, John, for your insightful reply. I always thought I was well hydrated because I drink 64 - 98 oz of water a day when I work out at the gym. Also I take my am and pm meds with 16 oz water each and drink fluids throughout the day. And my thyroid function has always been normal.

What is your opinion of an estimated glomerual filtration rate of 56.42?

I do however probably take too many NSAIDs because I am unable to sleep when uncomfortable despite ambien and clonazapam. I see my doc this afternoon to try to find effective alternative pain relief. Wondering if any naturapathic remedies might help improve kidney function...

OK that's good to know; that is probably adequate fluid intake, though I don't know how to guess how much extra fluid loss come from a gym session. It was just a shot in the dark for a possible reason.

56 is not at all bad (and don't even pay attention to the ".42"; that is really beyond the statistical reliability of the test). People tend to think that GFR is based on a 0-100 scale; it isn't. Remember that the unit of measure is "ml/min/1.73 m2 (males) and ml/min/1.72 m2 (females). And there is a different conversion factor for African-Americans than for Caucasians. The m2 is for "meters squared" which is an estimation of body surface area. Most of the eGFR (e being "estimated") don't take age, gender, body mass and ethnicity into account. So they aren't all that precise. Anything above 60 is basically considered a normal value.

So you are very close to that line. There is some natural and expected decline in function with every decade of age over 30. And depending on how often you work out, the regime could kick your numbers off by a few points. (I won't really go into why that happens, but in short, heavily stressed muscles undergo some damage, then they repair themselves as stronger than before. These damaged muscle cells leave damaged protein fragments in the blood and eventually the kidneys have to eliminate this stuff, and a lot of it goes out in creatinine. TADA! a slightly lowered eGFR.)

So if you were say 20 years old, I might want to watch a level of 56 carefully over a few years. But if you are over about 30 or 40, I think that it's a pretty good number.

The main thing to do is never to panic over one single test that is a few points higher or lower than the last one; watch the long term trend of theh numbers over years and decades, and see if there is a steady and sharp decline.

I can't comment on herbal etc treatments except to say that some are plainly dangerous so run everything by your doc. And avoid any extremely high protein diets for weight-loss or muscle building; most of them are expensive and just don't work for the long term.